What to do when a patient wants to record a patient-physician interaction in the emergency department

Abstract

Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. With no such governance for the general public, patients generally have greater freedom to record a patient-physician interaction. Unfortunately, there are no official policies from the provincial physician colleges regarding how best to proceed in these circumstances. Therefore, the onus is on individual hospitals and emergency departments (EDs) to develop their own policy on video recordings. A policy should ideally cover possible recording devices, locations, staff involved, and mandate that a written consent form be included with the patient's chart. While every request should be considered individually, physicians should generally not feel compelled to agree to the patient recording the clinical encounter. Patients are legally allowed to record a patient-physician interaction without consent of their physician, because the patient can provide the "one-party consent" for the conversation to be recorded. Physicians should accept the possibility that they are being recorded at all times and should strive to communicate as clearly and effectively as possible. Physicians should strive to provide the same level of care that they would even if they were not being recorded, and not let it interfere with their clinical decision-making.

Self-documentary in the emergency department: Perspectives on patients recording their own procedures

“…Although patient privacy is highly regulated by provincial legislation, much of the burden for privacy is placed on clinicians, leaving patients with relatively few regulations to follow. 5,7,8 This situation provides patients with greater freedom to record a patient-physician interaction. Current policy on ED video recording within the Saskatchewan Health Authority leaves the decision to record to the physician's discretion.…”

“…Currently, public policy on video recording in the healthcare setting is governed by provincial legislation and varies across Canada at each hospital or ED. 5,8,9 Although studies have looked at the use of video recording for educational and quality assurance purposes, as well as the value of recording the patient/ clinician interaction in clinical settings, 10,11 in our review of the literature, we found no studies quantifying how often patients are recording videos in the ED. We also found no studies detailing why patients want to record videos, or what the attitudes and practices of staff are concerning this practice.…”

“…Smartphones are now ubiquitous in our society, and, as the technology improves and their use increases and is compounded by the rapid growth of social media, [1][2][3][4] it is no longer an uncommon practice for patients and their family members or friends to attempt to capture the patient-physician interaction in the emergency department (ED). [4][5][6][7] In 2015, almost 73% of Canadians over the age of 18 owned a smartphone 3 ; therefore, it was expected that many patients would indicate that they owned a device capable of recording, which was the case for our study (81.8%). Currently, public policy on video recording in the healthcare setting is governed by provincial legislation and varies across Canada at each hospital or ED.…”

“…The request to video record is increasing, which has generated some controversy among staff, who have concerns about patient and staff confidentiality and covert recording. [12][13][14] With no current policy in place, the purpose of this study was to examine and compare patient and clinician (both physicians' and nurses') perspectives regarding patients video recording their own procedures in the ED and to lay the groundwork for further research and policy development regarding video recording and recording, in general, by patients in the ED.…”

Audiovisual recording in the emergency department: Ethical and legal issues

“…Clinicians in other specialties have used recordings to improve timely patientphysician interactions, particularly regarding understanding and recalling discharge instructions. 10 ED staff commonly record clinical images and test results (e.g., ECGs, radiographs) and, once de-identified, use them for academic purposes and for use by other treating clinicians, such as consultants, attending ED physicians and residents (with identifying information and transmitted via HIPAA-compliant modes).…”